NCSC Delegates Direct Academy to Develop Procedures Log

Advocates Say Service Would Benefit Recruiting, Retention of Members

The AAFP currently tracks members' CME activities as a member benefit. Now, delegates to the National Conference of Special Constituencies, or NCSC, have called on the Academy to offer a similar service for logging the procedures members perform.

David Nystrom, D.O., of Coon Rapids, Iowa, testifies before the Reference Committee on Practice Enhancement during the National Conference of Special Constituencies, or NCSC. Nystrom was co-author of a resolution adopted by NCSC delegates that calls for the AAFP to offer a procedure logging service.

"People love the CME log, and we're expanding on that," said new physician delegate Ravi Shah, M.D., of Oak Park, Ill., co-author of a resolution NCSC delegates adopted on May 7, during an interview with AAFP News Now. "A procedures log would have a similar effect."

Viviana Martinez-Bianchi, M.D., who is associate program director of the Duke Family Medicine Residency Program in Durham, N.C., testified in favor of the resolution during a May 6 hearing of the Reference Committee on Practice Enhancement.

"From a faculty perspective, I would find it extremely valuable to have a place my residents' procedures are tracked, that graduates can access at a later date," Martinez-Bianchi told AAFP News Now. "They'll need that in the future to show a credentialing committee and get privileges. It would be very helpful to have that service in a centralized place, just as we do with our CME credits. If you had that service through the Academy, no matter where you go, you would have access to that log. It's portable.

"They can also continue adding new procedures once they are in practice," she added.

According to Martinez-Bianchi, who also is chair of the AAFP Commission on Membership and Member Services, a procedures log would add "significant value" to membership. That could prove attractive to the roughly 30 percent of first-year new physicians who do not retain their AAFP memberships after they leave residency, she said.

New physician delegate David Nystrom, D.O., of Coon Rapids, Iowa, another co-author of the resolution, told AAFP News Now that residents receive CME credit during residency but don't start tracking their CME until they become new physicians. They do, however, start tracking their procedures as residents.

"This would be a hook right away for residents," Nystrom said. "You could say, AAFP is where it's at for this service, and it's going to be there forever."

Nystrom is a hospital-based family physician who also provides acute care and emergency services at three other local hospitals. He said he has had privileges at six hospitals in the past four years. He keeps a paper-based procedures log. Shah said he, too, uses a paper-based log and worries that it could get lost.

A third new physician delegate, Jon "Andy" Shull, M.D., of Granger, Ind., said he logs his procedures on an electronic spread sheet, but he acknowledged that system also has its pitfalls.

"It takes time to create it and manage it," he told AAFP News Now. "My computer crashed last night, and I was already about two weeks behind."

The reference committee voiced overwhelming support for the resolution in its report. Committee members said that in addition to tracking procedures for residencies and members seeking privileges, data could be collected regarding what residencies are teaching, which also could be helpful in identifying proctors skilled in various procedures. The committee agreed that such a system would benefit membership recruitment and retention and that it would "outweigh the considerable costs to develop and maintain it."

Among other procedures- and privileging-related measures NCSC delegates acted on were the following:

They approved a resolution that calls for the AAFP to consider scheduling a panel discussion at the 2012 Scientific Assembly to address the processes and challenges of privileging, as well as a similar panel discussion at the National Conference of Family Medicine Residents and Medical Students.

The practice enhancement reference committee recommended against creating a searchable database of family physician and specialist proctors because of potential cost concerns, and delegates agreed. The committee noted in its report that such a function could be included in the procedures tracking database, which, as noted above, delegates approved.

The same reference committee also recommended that delegates reject a resolution that called for the Academy to create a task force that would define basic competencies for relevant procedures and scope-of-practice parameters for members seeking privileges. However, that item was extracted from the consent calendar, amended and adopted by delegates. The final measure directed the AAFP to create a task force that "seeks evidence-based guidelines to define" such competencies.